Examining Trauma & HEROES IN CRISIS: What is PTSD and How Can a Comic Book Help?

When writer Tom King first introduced the concept of Heroes in Crisis to the public, he framed the story idea around the perception that a whole generation of Americans are dealing with the aftermath of trauma.

“I want to speak about, and to, this New War generation, the millions of people who have fought bravely overseas and have come home to try to return to their normal lives,” King said in a press conference at San Diego Comic Con.

King is a former counterterrorism operations officer with the CIA who experienced after-effects of his traumatic experience in Iraq and Afghanistan. He said he wants to use DC heroes to tell the stories of the people who are dealing with the mental effects of trauma. “I want to talk about their hopes, their pains, their triumphs.”

Heroes in Crisis isn’t the first time comic books have taken on social issues affecting their readers. From the depiction of Tony Stark’s alcoholism in the ‘70s to several characters dealing with the AIDs crisis in the ‘90s, comic books have regularly dealt with social issues that are troubling American society.

Credit: DC Comics

But Heroes in Crisis is unique because the subject of violence is central to superhero comic books. It’s also being approached with a pretty high profile, the publisher even using the word “Crisis” to indicate its importance (a word usually reserved for DC’s universe-shaking stories).

And although Heroes in Crisis is addressing the sort of violence that military and veterans — and superheroes — experience, the story is also dealing with a mass shooting, putting characters in a situation where a space that’s considered safe is invaded by violence.

With the release of Heroes in Crisis #1 less than a week away, Newsarama is running a series of stories looking at the mental effects of trauma, how those symptoms are treated, and how trauma is indelibly connected to superhero comic books. In this first story in our series, we take a look at King’s statement about how a generation of Americans are dealing with traumatic stress, and whether talking about that trauma can help.

How Prevalent is the Problem?

According to the National Center for PTSD at the U.S. Department of Veterans Affairs, about severn or eight percent of the U.S. population will have PTSD at some point in their life.

That percentage more than doubles for veterans of America’s military operations in the Middle East.

And Ken Duckworth, medical director of the National Alliance on Mental Illness, told Newsarama that statistics about PTSD don’t tell the whole story, because the mental effects of trauma stretch beyond just one disorder.

“Not everybody develops full-on PTSD with flashbacks and nightmares and feeling cut-off from your emotions,” Duckworth said, referring to the long list of criteria for a PTSD diagnosis (available on the PTSD.va.gov website). A lot of people can exist on a spectrum of that.

“There’s a pretty wide range of experiences to trauma that are short of post traumatic stress disorder,” Duckworth explained. “Some people have panic attacks years later. Some people feel a generalized sense of anxiety. Some people avoid tasks that are anyway related to that … You have intrusive thoughts. Or you feel anxious a lot of the times. Or you get kind of depressed or despairing. Some people have physical symptoms, which is more common in kids and adolescents. They have physiologic responses like stomach upsets, headaches, fatigue, wishing to be asleep.”

Terry Keane, director at the National Center for PTSD, told Newsarama that another common symptom for people struggling after trauma is addiction.

Keane said that although trauma-related mental illness is a real problem for combat veterans who have seen action or experienced violence — particularly repeated exposure to violence — diagnoses in the United States are often not related to combat.

“It’s domestic violence and sexual assault and industrial accidents and motor vehicle accidents and community violence,” Keane said, adding that it’s most prevalent among people who have experienced numerous traumatic incidents. “And those are things we’ve learned … is how prevalent exposure to trauma — life and death situations is what trauma means — how common it is in the general population, and how much PTSD is out there.”

Is This Something New?

Dr. Keane said the beginnings of Department of Veterans Affairs where he works can be traced back to the Civil War, and so can the symptoms of trauma-related mental illness.

“There were very clear indicators in the Civil War about something that was referred to as ‘Soldier’s Heart,’ which basically was a sadness about the experiences of war and the horrors of war,” Keane said. “‘Shell Shock’ was specific to veterans of World War I. And people who had the ‘Thousand Yard Stare.’ It was thought to be related to, perhaps, the trauma of the war and the explosions and the blasts that the people in the trenches were experiencing, which of course were horrendously frightening experiences for people. And throw in mustard gas or the flamethrowers and you can understand why people would have been frightened or would have developed psychological reactions and perhaps even become disabled by their experiences.

“That was one of the big marker points, actually, was World War I,” Keane said, although veterans have been dealing with mental symptoms of trauma ever since.

More recently, the crisis of 9/11 — combined with the rise in terrorism and the war against it — gave researchers the opportunity to further refine their understanding of how trauma affects people psychologically.

What Have We Learned?

“We can diagnose PTSD very, very well in clinic settings — and in epidemiological settings and surveys,” Keane said. “We can identify it very, very well.”

Duckworth said psychologists have also discovered that not everyone needs counseling after a traumatic experience, and not everyone will develop mental symptoms in the same way.

“It’s very interesting. We don’t understand that,” he said. “Does it have to do with their prior family history, their own childhood experiences, some physiologic vulnerability that they have that we don’t understand yet? It’s a very interesting question that we’re still sorting out.”

Psychologists have also learned that after a major traumatic event, counseling should be offered, but not required. “They came to the conclusion that if 50 people are in an earthquake, it is not helpful to an intense debrief of everyone,” Duckworth explained. “Crisis incidents stressed debriefing, CISD, was briefly very en vogue. And then they realized it’s not helpful to dig out the truth from everyone. That’s not a helpful approach. So some people will process this normally. It will pass for some people.”

But the most signficant information researchers have learned, Duckworth said, is that it’s important to seek help if symptoms occur.

“That’s really important, because if you don’t get help or you can’t get help,” he said, “then turning to counter-productive strategies is a big risk.”

Can ‘Heroes in Crisis’ Help?

Duckworth said the main benefit he sees from Heroes in Crisis is showing that even the strongest among us need psychological help sometimes — and getting the help you need isn’t a weakness.

“I would describe it as a vulnerability as opposed to a weakness,” said Duckworth. “You’re exposed to something that’s traumatic, whatever it may be on planet Krypton or the loss of your parents or being injected by spider venom, there’s a traumatic dimension to a lot of those kinds of stories.

“I think it’s really fabulous that there is a more psychological freedom for this character,” Duckworth said. “I want to say that I really applaud this writer. It’s very creative.”

The psychologist said he hopes the story will encourage people who are experiencing symptoms of PTSD to get help. “Don’t ignore symptoms. Don’t ignore symptoms,” he said. “Get help. It’s consistent with strength to address a vulnerability. It’s not a weakness.”

“Most people who develop PTSD have no idea that there’s a disorder,” Keane said. “They sort of blame themselves, or they just think of themselves as weak or inadequate. And the truth of the matter is they have a readily identifiable psychological disorder, which we call now PTSD.

“But the second piece of that is … there are treatments available,” he said, “and these treatments can be very helpful for people who come forward.”

Check back for future installments of Newsarama’s Heroes in Crisis tie-in series exploring superhero comic books and the mental effects of trauma, including more information about real-life treatment (and its connection to the comic book’s “Sanctuary”) and the indelible link between superheroes and trauma.